Catching up with catch-up: a policy analysis of immunisation for refugees and asylum seekers in Victoria
Georgia A. Paxton A E , Pete C. G. Spink B , Margaret H. Danchin C , Lauren Tyrrell B , Chelsea L. Taylor D , Susan Casey B and Hamish R. Graham C
+ Author Affiliations
- Author Affiliations
A The Royal Children’s Hospital, General Medicine, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Vic. 3052, Australia.
B Victorian Refugee Health Network, 4 Gardiner Street, Brunswick, Vic. 3056, Australia.
C The Royal Children’s Hospital, General Medicine, Murdoch Children’s Research Institute, Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, Vic. 3052, Australia.
D Victorian Department of Health and Human Services, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia.
E Corresponding author. Email: georgia.paxton@rch.org.au
Australian Journal of Primary Health 24(6) 480-490 https://doi.org/10.1071/PY17049
Submitted: 23 May 2017 Accepted: 23 May 2018 Published: 3 October 2018
Abstract
This study examines catch-up immunisation for people of refugee-like background in Victoria, exploring effective models of service delivery to complete catch-up vaccinations. The analysis is based on: (i) review of the medical literature, Commonwealth and Victorian government immunisation policy and immunisation patient information; (ii) review of vaccination coverage and service delivery data; and (iii) stakeholder interviews completed in 2014 with 45 people from 34 agencies, including 9 local government areas in Victoria. Although refugees and asylum seekers all need catch-up vaccinations on arrival, they face significant barriers to completing immunisation in Australia. Analysis suggests missed opportunities by service providers and perceptions that catch-up vaccination is time-consuming, difficult and resource-intensive. Service delivery is fragmented across primary care and local government, and pathways depend on age, location and healthcare access. There are strengths, but also limitations in all current service delivery models. Gaps in vaccine funding for refugee-like populations have now been addressed through Commonwealth initiatives, however migration is still not well considered in immunisation policy, and existing systems for notification payments do not capture catch-up vaccination for these groups. Providers identify areas for improvement in professional development and support, patient information, patient-held records and immunisation surveillance data.
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